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患儿男,9岁。因全身皮肤黄染、发热乏力、腹痛10天,在当地医院诊为黄疸型肝炎,在家治疗,效不佳,且黄疸加重,尿如浓茶色,来我院诊。门诊查血常规:红细胞1.53×10~(12)/L,血红蛋白42g/L,网织红细胞0.122,以溶血性贫血收住院治疗。入院体检:体温37.8℃,脉搏98次/分,呼吸24次/分。神志清,精神不振。皮肤及巩膜明显黄染。心肺正常。腹软,肝肋下2.5cm,质中,触痛明显,脾肋下1.0cm,总胆红素104μmol/L,直接胆红素31μmol/L,间接胆红素73μmol/L,GPT0.65μkat/L,直接Coomb’s试验阴性。骨髓常规检查正常,脑电图广泛轻度异常,K—F环(+),血清铜蓝蛋白124mg/L
Children male, 9 years old. Due to body yellow dye, fever, abdominal pain for 10 days, diagnosed with jaundice hepatitis in the local hospital, at home, poor efficacy, and increased jaundice, urine, such as strong brown, to my hospital. Outpatient examination of blood routine: red blood cells 1.53 × 10 ~ (12) / L, hemoglobin 42g / L, reticulocytes 0.122, to hemolytic anemia received hospital treatment. Admission medical examination: body temperature 37.8 ℃, pulse 98 beats / min, breathing 24 beats / min. Consciousness, lack of energy. Skin and sclera obvious yellow dye. Cardiopulmonary normal. Abdominal soft, liver ribs 2.5cm, quality, tenderness, splenic ribs 1.0cm, total bilirubin 104μmol / L, direct bilirubin 31μmol / L, indirect bilirubin 73μmol / L, GPT 0.65μkat / L, direct Coomb’s test negative. Bone marrow routine examination was normal, EEG extensive mild abnormalities, K-F ring (+), serum ceruloplasmin 124mg / L